Waiting time analysis in a paediatric outpatient clinic in South East Nigeria

Main Article Content

Onyinye Anyanwu
Thecla Ezeonu
Lauretta Orji
Obumneme Ezeanosike
Charles Ikegwuonu
Kenneth Omeje
Vivian Asiegbu
Emeka Onwe
Benson Onyire


Objective:  Waiting time is a resource investment by the patient for the desired goal of being attended to by the physician. It is the time taken  or spent in waiting to be attended to by a physician in a health facility. It is important because waiting time is an essential determinant of patient satisfaction in health care practice, and its study would expose the bottleneck areas in patient’s time-flow so that the facility can improve services with that regard.

Materials and Methods: A cross-sectional study of time spent by paediatric patients in the outpatient department of Alex Ekwueme Federal University Teaching Hospital Abakaliki by secretly following the patients from arrival at CHOP till after consultation. Means were calculated of time spent in various areas. 

Results: Of the 384 patients observed, the mean (SD) total time spent in the hospital was 142.58 (23.17) minutes while waiting time and consultation time were 113.15(18.01) and 24.43 (10.38) minutes respectively. The mean time spent at the nurse’s bay was 23.79 (6.47) minutes, while that spent at the queue was 22.94 (8.98) minutes. The time spent at the records unit was the highest, with a mean time of 47.2 (17.42) minutes. 

Conclusion: The long waiting time obtained from the current study is mostly attributable to delays from the records/registration unit, therefore conceited efforts aimed at improvement of service delivery in this unit will reduce patient waiting time and invariably patient satisfaction.


Download data is not yet available.

Article Details

How to Cite
Anyanwu, O., Ezeonu, T., Orji, L., Ezeanosike, O., Ikegwuonu, C., Omeje, K., Asiegbu, V., Onwe, E., & Onyire, B. (2021). Waiting time analysis in a paediatric outpatient clinic in South East Nigeria. Medical Science and Discovery, 8(2), 50-59. https://doi.org/10.36472/msd.v8i2.459
Research Article


1. Potisek NM, Malone RM, Shilliday B.B, et al. Use of patient flow analysis to improve patient visit efficiency by decreasing wait time in a primary care-based disease management programs for anticoagulation and chronic pain: a quality improvement study. BMC Health Serv Res 2007;7:8

2. Lynam PF, Smith T, Dwyer J. Client flow analysis: a practical management technique for outpatient clinic settings. Int J Qual Health Care. 1994;6(2):179-186.

3. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press; 2001.

4. Leddy KM, Kaldenberg DO, Becker BW. Timeliness in ambulatory care treatment. An examination of patient satisfaction and wait times in medical practices and outpatient test and treatment facilities. J Ambul Care Manage. 2003;26(2):138–149.

5. Babalola D, Meng YX, Nichols M, Omole F, Sow C, Perkins V. Improving the patient flow at an academic primary care teaching clinic serving African American patients. Clin Exp Med Sci. 2013;1(5):241–250.

6. Hill CJ, Joonas K. The impact of unacceptable wait time on health care patients’ attitudes and actions. Health Mark Q. 2005;23(2):69–87.

7. Potisek NM, Malone RM, Shilliday BB, et al. Use of patient flow analysis to improve patient visit efficiency by decreasing wait time in a primary care-based disease management programs for anticoagulation and chronic pain: a quality improvement study. BMC Health Serv Res. 2007;7:8

8. O’Malley MS, Fletcher SW, Fletcher RH, Earp JA. Measuring patient waiting time in a practice setting: A comparison of methods. J Ambul Care Manage 1983;6:20-27

9. dos Santos LM, Stewart G, Rosenberg NM. Pediatric emergency department walk-outs.PediatrEmerg Care 1994;10(2):76-78

10. Singh H, Haqq ED, Mustapha N. Patients’ perception and satisfaction with health care professionals at primary care facilities in Trinidad and Tobago. Bull World Health Organ. 1999;77:356–360

11. Ofilli AN, Ofowve CE. Patient's assessment of efficiency of services at a teaching hospital in a developing country. Ann Afr Med. 2005;4:150–153

12. Okolo SN, Ogbonna C, Bode-Thomas F. Healthcare service auditing and intervention in an emergency Paediatric unit. Nig J Paed 2002;29:71-74

13. Oche MO. Adamu H. Determinants of Patient Waiting Time in the General Outpatient Department of a Tertiary Health Institution in North Western Nigeria. Ann, Med, Health. Sci. Res. 2013;3(4):588-592. doi: 10.4103/2141-9248.122123

14. Bamgboye EO, Erinoso HO, Ogunlesi AO. The waiting time at the children's emergency room, University College Hospital, Ibadan. Nig J Pediatr. 1994;19:9–14
15. Huang XM. Patient attitude towards waiting in an outpatient clinic and its applications. Health Serv Manage Res 1994;7(1):2-8

16. Fitzpatrick R. Surveys of Patients’ satisfaction: Important general consideration. Br Med J 1991; 302:887-889

17. Goodacre S, Webster A. Who waits the longest in the emergency department and who leaves without being seen? Emerg Med J 2005;22:93-96

18. National bureau of statistics. Annual Abstract of Statistics, 2011. Federal Republic of Nigeria. Pg 34

19. Araoye MA. Sample size determination. In: Research methodology with statistics for health and social sciences. 1st ed. Illorin: Nathadex Publishers; 2003. p. 115‑121.

20. Akintomide AO, Ukweh ON, Efanga SA. An audit of the appointment booking system and patient waiting time in an ultrasound unit in Nigeria: A need to eliminate congestion in our public hospitals. Journal of family medicine and primary care. 2019 Jun;8(6):2055.

21. Anderson R, Barbara A, Feldman S. What patients want: a content analysis of key qualities that influence patient satisfaction. J Med Pract Manage. 2007;22(5):255-261.

22. Hasanpoor-Azghdy SB, Simbar M, Vedadhir A. The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study. Iranian journal of reproductive medicine. 2014;12(2):131.

23. Barlow GL. Auditing hospital queuing. Managerial Auditing J. 2002 17(7):397–403

24. Bielen F, Demoulin N. Waiting time influence on the satisfaction‐loyalty relationship in services. Journal of Service Theory and Practice. 2007;17(2):174-193

25. Ahmad BA, Khairatul K, Farnaza A. An assessment of patient waiting and consultation time in a primary healthcare clinic. Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia. 2017;12(1):14.

26. Patel R, Patel HR. A study on waiting time and out-patient satisfaction at Gujarat medical education research society hospital, Valsad, Gujarat, India. Int J Community Med Public Health. 2017;4(3):857-863.

27. Aswar NR, Kale KM, Rewatkar MP, Jain AA, Barure BS. Patients Waiting Time and their Satisfaction of Health Care Services Provided at Outpatient Department of Government Medical College, Nanded Maharashtra-India. International Journal of Contemporary Medicine. 2014;2(2):72-76.

28. Babalola D, Meng YX, Nichols M, Omole F, Sow C, Perkins V. Improving the patient flow at an academic primary care teaching clinic serving African American patients. ClinExp Med Sci. 2013;1(5):241-250.

29. Virmani V, Bansal AK, Pandit DP, Howale DS. Waiting time analysis at outpatient department at GMERS Medical College Hospital, Valsad. International J Scientific Research. 2014;3(2):280-282.

30. Sharma SK, Chowhan SS. Patient Waiting Time: It’s Impact on Hospital Outpatient Department. International J Scientific Research. 2013;2(3):253-254.

31. Wafula F, Dolinger A, Daniels B, Mwaura N, Bedoya G, Rogo K, Goicoechea A, Das J, Olayo B. Examining the quality of medicines at kenyan healthcare facilities: a validation of an alternative post-market surveillance model that uses standardized patients. Drugs-real world outcomes. 2017;4(1):53-63.

32. Zoller JS, Lackland DT, Silverstein MD. Predicting patient intent to return from satisfaction scores. The Journal of ambulatory care management. 2001;24(1):44-50.

33. Kreitz TM, Winters BS, Pedowitz DI. The influence of wait time on patient satisfaction in the orthopedic clinic. Journal of patient experience. 2016;3(2):39-42.

34. McCarthy K, McGee HM, O'Boyle CA. Outpatient clinic waiting times and non-attendance as indicators of quality. Psychology, health & medicine. 2000;5(3):287-293.

35. Oyelere BA, Raji SA, Oyeyemi GM, Salami AO, Bello FW. Efficient health care service delivery using network analysis: a case study of Kwara State, Nigeria. Ethiopian Journal of Environmental Studies and Management. 2017;10(2):186-191.

36. Ogu RN, Ntoimo LF, Okonofua FE. Perceptions of women on workloads in health facilities and its effect on maternal health care: A multi-site qualitative study in Nigeria. Midwifery. 2017;55:1-6.

37. Okonofua F, Ogu R, Agholor K, Okike O, Abdus-Salam R, Gana M, Randawa A, Abe E, Durodola A, Galadanci H. Qualitative assessment of women’s satisfaction with maternal health care in referral hospitals in Nigeria. Reproductive health. 2017;14(1):44.

38. Pillay DI, Ghazali RJ, Manaf NH, Abdullah AH, Bakar AA, Salikin F, Umapathy M, Ali R, Bidin N, Ismail WI. Hospital waiting time: the forgotten premise of healthcare service delivery? Int J Health Care QualAssur. 2011;24(7):506–22. doi: 10.1108/09526861111160553.